STORY AT-A-GLANCE

  • Five classes of oral antibiotics have been identified as risk factors for kidney stones: broad-spectrum penicillins, fluoroquinolones, nitrofurantoin, cephalosporins and sulfas
  • The association is most pronounced among younger children, and remains statistically significant for up to five years after exposure, except for broad-spectrum penicillin
  • Between 1997 and 2012, the annual incidence of kidney stone disease rose by 16%. The highest increase was seen in 15- to 19-year-olds, among whom the incidence rate increased 26% per 5 years
  • Previous studies have found an association between oral antibiotics and inflammatory bowel disease (IBD) and colorectal cancer, likely due to disruption of gut microbiome
  • Fluoroquinolones, which are frequently prescribed for upper respiratory infections and urinary tract infections (UTIs) have been linked to an increased risk for aortic dissection (tears in the aorta), which can be fatal

According to research1 published in the Journal of the American Society of Nephrology (JASN) in 2018, oral antibiotics are a risk factor for kidney stones. Health records for 13 million children and adults in the U.K. were reviewed, showing that exposure to five classes of oral antibiotics were associated with kidney stones within three to 12 months post-use. The adjusted odds ratio of kidney stones was:

  • 1.27 for broad-spectrum penicillin
  • 1.67 for fluoroquinolones
  • 1.70 for nitrofurantoin/methenamine
  • 1.88 for cephalosporins
  • 2.33 for sulfas

The association was most pronounced among younger children and remained statistically significant for up to five years after exposure, with the exception of broad-spectrum penicillin. The authors concluded that:2

“Oral antibiotics associated with increased odds of nephrolithiasis [kidney stones], with the greatest odds for recent exposure and exposure at younger age. These results have implications for disease pathogenesis and the rising incidence of nephrolithiasis, particularly among children.”

Kidney Stones in Children Are on the Rise

If this link is true, then we’d expect to see rising rates of kidney stones in young patients, and that’s precisely what we’re seeing. As reported by NBC News, July 8, 2023,3 data show kidney stones are “now occurring in younger people, particularly among teenage girls,” and “diets high in ultraprocessed foods” and “increased use of antibiotics early in life” are thought to be among the key contributors to this trend.

Between 1997 and 2012, kidney stones during childhood doubled.

According to research4 published in the Clinical Journal of the American Society of Nephrology in 2016, between 1997 and 2012, the mean annual incidence of kidney stone disease across age groups increased 1% annually, from 206 to 239 per 100,000 persons.

The highest increase was seen in 15- to 19-year-olds, among whom the incidence rate increased 26% per 5 years. Within this age group, incidence was 52% higher among girls. In men, kidney stones became more common after age 25. According to the authors:5

“These changes in incidence resulted in doubling of the risk of nephrolithiasis during childhood and a 45% increase in the lifetime risk of nephrolithiasis for women over the study period.”

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